During the first two years of this investigation, a Retrospective Study of eleven major burn care facilities has been carried out with data submitted to the National Burn Information Exchange (NBIE). Initially it was found that patterns of survival rates relative to severity differed considerably among institutions after controlling for the age and sex of patients. Further analysis has shown that these differences persist after controlling for several additional variables. An Institutional Review Study has been designed and implemented through site visits to evaluate the quality and effectiveness of burn patient care and, in conjunction with the Retrospective Study, to explain differences in the outcomes of care. Results from the two studies also will be used to develop new baseline curves for patient survival relative to many prognostic variables and to develop standards for patient care which, if applied, will improve burn patient care. Other research objectives are to refine the current data gathering instrument and procedures, to continue the study of the initial eleven institutions to determine trends in care over time and, particularly, to evaluate the effects of feedback from the first two years of study, to assess the validity and reproducibility of the current studies on other burn care facilities which are also presently participants in the NBIE, and to study the feasibility of extending the project to nonspecialized burn care facilities.